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Archive for February, 2008

Five Months and Some Milestones

Posted in My precious angels, parenting, triplet mania on February 19, 2008| 11 Comments »

My babies are FIVE MONTHS OLD today. Can you believe that I’m such a lazy sloth that in FIVE MONTHS I still haven’t managed to write about the day of their birth??? Man, I suck. Maybe before they’re six months old. Hah, I say, Hah!

It didn’t escape my notice, though I failed to find the time to make a blog post, that February 14th marked an anniversary for us. A year ago, in the midst of a pretty nasty ice storm, despite J having school cancelled, and terrible road conditions, S and I dragged ourselves out to the clinic for IUI day, for an IUI that was doomed to fail. The IUI was SO definitely going to fail that I had my IVF consult two days later and Dr. Amazing told me flat out that it was time to move on, and there was no way I was going to get a positive beta out of that ridiculous cycle. Everything went wrong with that cycle. Everything. Except my three precious miracles. They were right. A year later and here I am, looking at my three beautiful babies, and I know that no matter how WRONG that cycle was… everything was exactly right.

I cried tears of emptiness every day that I didn’t have any babies in my arms. And I cry tears of joy every day now that my beautiful babies are here. S heard me say that to someone recently and asked if I meant that literally. “I mean, I know that I’m dense sometimes, but did I miss you crying every day?” In the beginning, no, I didn’t literally cry tears every single day… but by the end… yeah, I really did. Not sobbing, wretching, buckets of tears, but I wiped a tear or two off my cheek every day toward the end. Especially after the miscarriage. And now, sometimes I stand over my babies’ crib at night and hold their tiny little hands as they sleep and I’m so overwhelmed with joy and love and even a little sadness for all the years of loss… that I still wipe a tear away. But these are hard-earned tears, and I wouldn’t give them up for anything.

And our babies…our beautiful babies… they’re growing up. I went through and took out all their Newborn clothes from their shelves. And I even took out all of Sam’s 0-3 month sized clothes. Ellie still fits in 0-3 month clothes (and even some NB clothes, but I put those away anyway, since she’s not lacking for clothes). They’re getting bigger every day, and it’s so funny to see it happen right before my eyes. My nanny tells me things don’t fit and I don’t believe her and then I take a look and it’s true! How could this be!? But, despite my belief that they are as teeney as the day they were born, they just aren’t. Abby is over three times her birth weight, and Sam is getting close to three times his birth weight. Ellie’s not there yet, but she’s finally double her birth weight, which is astounding. They just keep getting bigger and bigger.

In other milestones, Sam learned a new trick last week… If I leave the room and he cries, I come back! Yep, he’s got me wrapped around his little finger. And when I walk back in the room, he smiles and coos and calms right down. And then if I walk back out of the room, he starts fussing again! And so it goes… He’s still my little piggy and he wants to eat ALL NIGHT LONG nearly every hour and I have no idea how to break him of this habit, because he’s clearly truly hungry when he wakes up. I tried explaining to him logically last night that Dr. B. said that at his weight he should be ABLE to sleep through the night, but Sam was having nothing to do with it and he responded quite indignantly.

Abby is our smiliest baby who coos the most of all. Yesterday S even got her to giggle for the first time! More significantly, this week she started sleeping laying flat in the pack n’ play. She had been sleeping in a bouncy chair, which was really aggravating, because I was totally convinced she was never going to sleep in a crib, ever, but it’s finally happening! Best of all, she wakes up happy and smiling in the morning, which is a beautiful thing.

Ellie didn’t grow at all last week, but it’s clear that she’s growing now. She’s far more alert now than she was even last week, and she’s not nearly so skeletal looking. You can still see her ribs, but her thighs are chunking out a little and her face has a little more pudge to it. She’s finally got enough fat on her face that we’ve discovered she has dimples! Now that she’s more alert, she’s been rewarding us with lots of beautiful smiles. She’s also been fussing more than she had been, but I take that as a sign that she’s more aware of her environment, so it’s a good thing. She has another appointment on Friday, and I expect that she will have grown a bit then, so we’ll see. She still has a gastroenterology follow up scheduled next week. I haven’t cancelled it yet, but I suspect I might. I feel like her pediatrician is handling it appropriately and I don’t see how the gastroenterologist will really add anything of value at this point. We’ll see.

My father and his wife are coming to visit this weekend. It’s the first time they’ve seen the babies since the day the babies were discharged from the NICU, over four months ago. Amazing how time flies when you’re sleep-deprived. In many ways, parenting triplets (so far) has been a million times easier than I expected it to be. In other ways, it has been far more challenging than I could ever describe. I don’t feel like it’s more than I can handle, but I feel terribly inadequate for the job. I fear that I will be an inadequate parent for my children…that I will shortchange them in ways that I might not have if I’d had them one at a time. I fear that they will miss out on the individual attention they should be getting. I fear that J is missing out on individual attention that HE should be getting right now. But I also know that these are all fears I’d be having even with a singleton. I know that all parents fear inadequacy, and I know that the only thing I can ask of myself is that I strive to be the best parent I CAN be on any given day. Some days that will be enough, and some days it won’t be, but every day it will be as much as it can be and that’s really all I can ask of myself today.

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Five Months and Some Milestones

Posted in My precious angels, parenting, triplet mania on February 19, 2008| 10 Comments »

My babies are FIVE MONTHS OLD today. Can you believe that I'm such a lazy sloth that in FIVE MONTHS I still haven't managed to write about the day of their birth??? Man, I suck. Maybe before they're six months old. Hah, I say, Hah!

It didn't escape my notice, though I failed to find the time to make a blog post, that February 14th marked an anniversary for us. A year ago, in the midst of a pretty nasty ice storm, despite J having school cancelled, and terrible road conditions, S and I dragged ourselves out to the clinic for IUI day, for an IUI that was doomed to fail. The IUI was SO definitely going to fail that I had my IVF consult two days later and Dr. Amazing told me flat out that it was time to move on, and there was no way I was going to get a positive beta out of that ridiculous cycle. Everything went wrong with that cycle. Everything. Except my three precious miracles. They were right. A year later and here I am, looking at my three beautiful babies, and I know that no matter how WRONG that cycle was… everything was exactly right.

I cried tears of emptiness every day that I didn't have any babies in my arms. And I cry tears of joy every day now that my beautiful babies are here. S heard me say that to someone recently and asked if I meant that literally. "I mean, I know that I'm dense sometimes, but did I miss you crying every day?" In the beginning, no, I didn't literally cry tears every single day… but by the end… yeah, I really did. Not sobbing, wretching, buckets of tears, but I wiped a tear or two off my cheek every day toward the end. Especially after the miscarriage. And now, sometimes I stand over my babies' crib at night and hold their tiny little hands as they sleep and I'm so overwhelmed with joy and love and even a little sadness for all the years of loss… that I still wipe a tear away. But these are hard-earned tears, and I wouldn't give them up for anything.

And our babies…our beautiful babies… they're growing up. I went through and took out all their Newborn clothes from their shelves. And I even took out all of Sam's 0-3 month sized clothes. Ellie still fits in 0-3 month clothes (and even some NB clothes, but I put those away anyway, since she's not lacking for clothes). They're getting bigger every day, and it's so funny to see it happen right before my eyes. My nanny tells me things don't fit and I don't believe her and then I take a look and it's true! How could this be!? But, despite my belief that they are as teeney as the day they were born, they just aren't. Abby is over three times her birth weight, and Sam is getting close to three times his birth weight. Ellie's not there yet, but she's finally double her birth weight, which is astounding. They just keep getting bigger and bigger.

In other milestones, Sam learned a new trick last week… If I leave the room and he cries, I come back! Yep, he's got me wrapped around his little finger. And when I walk back in the room, he smiles and coos and calms right down. And then if I walk back out of the room, he starts fussing again! And so it goes… He's still my little piggy and he wants to eat ALL NIGHT LONG nearly every hour and I have no idea how to break him of this habit, because he's clearly truly hungry when he wakes up. I tried explaining to him logically last night that Dr. B. said that at his weight he should be ABLE to sleep through the night, but Sam was having nothing to do with it and he responded quite indignantly.

Abby is our smiliest baby who coos the most of all. Yesterday S even got her to giggle for the first time! More significantly, this week she started sleeping laying flat in the pack n' play. She had been sleeping in a bouncy chair, which was really aggravating, because I was totally convinced she was never going to sleep in a crib, ever, but it's finally happening! Best of all, she wakes up happy and smiling in the morning, which is a beautiful thing.

Ellie didn't grow at all last week, but it's clear that she's growing now. She's far more alert now than she was even last week, and she's not nearly so skeletal looking. You can still see her ribs, but her thighs are chunking out a little and her face has a little more pudge to it. She's finally got enough fat on her face that we've discovered she has dimples! Now that she's more alert, she's been rewarding us with lots of beautiful smiles. She's also been fussing more than she had been, but I take that as a sign that she's more aware of her environment, so it's a good thing. She has another appointment on Friday, and I expect that she will have grown a bit then, so we'll see. She still has a gastroenterology follow up scheduled next week. I haven't cancelled it yet, but I suspect I might. I feel like her pediatrician is handling it appropriately and I don't see how the gastroenterologist will really add anything of value at this point. We'll see.

My father and his wife are coming to visit this weekend. It's the first time they've seen the babies since the day the babies were discharged from the NICU, over four months ago. Amazing how time flies when you're sleep-deprived. In many ways, parenting triplets (so far) has been a million times easier than I expected it to be. In other ways, it has been far more challenging than I could ever describe. I don't feel like it's more than I can handle, but I feel terribly inadequate for the job. I fear that I will be an inadequate parent for my children…that I will shortchange them in ways that I might not have if I'd had them one at a time. I fear that they will miss out on the individual attention they should be getting. I fear that J is missing out on individual attention that HE should be getting right now. But I also know that these are all fears I'd be having even with a singleton. I know that all parents fear inadequacy, and I know that the only thing I can ask of myself is that I strive to be the best parent I CAN be on any given day. Some days that will be enough, and some days it won't be, but every day it will be as much as it can be and that's really all I can ask of myself today.

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Answer to Anonymous

Posted in breastfeeding, FAQ on February 17, 2008| 1 Comment »

I still hate that Blogger doesn’t do threaded comments, so I’ll respond to Anonymous’ questions on pumping here:

While driving to and from work can you steal some additional pumping sessions using something like a Whisper Wear pump?

My commute to work, thankfully, is really too short for this to be useful. And I do pump while at work, of course, but there’s just only so many times I can do that. I’ll point out that the Whisper Wear Pump has been discontinued by the manufacturer. While I don’t know why, my guess is it’s because it doesn’t work. I actually have a Whisper Wear Pump and my experience is… it doesn’t work (and, oh by the way, it’s LOUD). From the reviews I can find online, it seems that it definitely does not work with women who are, uh, how shall I say… ahem… well endowed. And people who are small breasted seem to have only minimally good experience with it. I’m in the well-endowed category and I can’t get a drop out of it, so I found it to be a phenomenal waste of money.

While a baby nurses from one side can you hand pump the other?

If I’m nursing only one baby, and I haven’t recently pumped, I nearly always pump the other side. But I don’t use a hand pump, I use my hospital-grade electric pump for that. But it also depends on whether I’m about to nurse another baby. My experience is that if I pump and then feed a baby, the baby doesn’t get enough (remember that I weigh Ellie before and after feeding her, so I do have a quantitative way of measuring this), so if I’m feeding Sam and I know that I’m going to be feeding Ellie immediately afterward, I might pump for a few minutes on the other side just to get to the hindmilk stage (higher calorie), but I won’t do a full pumping session. I am often, however, feeding two babies at once, so there’s nothing to pump at the same time. (I’ve backed off on simultaneous feeding recently, because I’m finding Ellie doesn’t eat as much if I feed them both at the same time… I’m not sure why this is, but it seems consistently true)

I do often pump AFTER nursing the babies, because in THEORY this is supposed to boost my supply. However, my experience is that I nearly NEVER get more than a couple cc’s if I pump after feeding the babies. They’re pretty good at fully draining me, which is a good thing. I can’t pump after nursing them EVERY time they nurse, because, honestly, there are only so many hours in the day.

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Answer to Anonymous

Posted in breastfeeding, FAQ on February 17, 2008| 1 Comment »

I still hate that Blogger doesn't do threaded comments, so I'll respond to Anonymous' questions on pumping here:

While driving to and from work can you steal some additional pumping sessions using something like a Whisper Wear pump?

My commute to work, thankfully, is really too short for this to be useful. And I do pump while at work, of course, but there's just only so many times I can do that. I'll point out that the Whisper Wear Pump has been discontinued by the manufacturer. While I don't know why, my guess is it's because it doesn't work. I actually have a Whisper Wear Pump and my experience is… it doesn't work (and, oh by the way, it's LOUD). From the reviews I can find online, it seems that it definitely does not work with women who are, uh, how shall I say… ahem… well endowed. And people who are small breasted seem to have only minimally good experience with it. I'm in the well-endowed category and I can't get a drop out of it, so I found it to be a phenomenal waste of money.

While a baby nurses from one side can you hand pump the other?

If I'm nursing only one baby, and I haven't recently pumped, I nearly always pump the other side. But I don't use a hand pump, I use my hospital-grade electric pump for that. But it also depends on whether I'm about to nurse another baby. My experience is that if I pump and then feed a baby, the baby doesn't get enough (remember that I weigh Ellie before and after feeding her, so I do have a quantitative way of measuring this), so if I'm feeding Sam and I know that I'm going to be feeding Ellie immediately afterward, I might pump for a few minutes on the other side just to get to the hindmilk stage (higher calorie), but I won't do a full pumping session. I am often, however, feeding two babies at once, so there's nothing to pump at the same time. (I've backed off on simultaneous feeding recently, because I'm finding Ellie doesn't eat as much if I feed them both at the same time… I'm not sure why this is, but it seems consistently true)

I do often pump AFTER nursing the babies, because in THEORY this is supposed to boost my supply. However, my experience is that I nearly NEVER get more than a couple cc's if I pump after feeding the babies. They're pretty good at fully draining me, which is a good thing. I can't pump after nursing them EVERY time they nurse, because, honestly, there are only so many hours in the day.

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On Breastfeeding Triplets

Posted in breastfeeding, failure to thrive, my stupid body on February 15, 2008| 25 Comments »

You’re pregnant with triplets? Well, you’re obviously not going to breastfeed them, you’re going to spend a fortune on formula!

I heard that a lot when I was pregnant. Over and over, I heard unsolicited opinions from people telling me that there was no way I would ever be able to breastfeed triplets. It’s not possible, they would say. I didn’t even bother trying with my twins, I would hear. Why would you even think about it? You’ll never do anything but feed them all day long if you try! the incredulous voices would cry. They’ll be preemies. You can’t breastfeed preemies, you know.

I never expected to be the militant type…certainly not about breastfeeding, and certainly not about breastfeeding triplets. But these constant, unsolicited words of discouragement absolutely convinced me that I was going to do everything I could to breastfeed my babies, at least for the first few weeks. My premature babies were going to NEED the benefit of my colostrum and my milk for as long as I could give it to them, and I knew it wouldn’t be forever, and even during my pregnancy, I mourned the loss of the ability to just KNOW that I could breastfeed with reckless abandon, but I set a modest goal. I wanted to get 3-4 weeks of exclusive breast milk into them if I could. And if I could do that, well, we’d go for 6 weeks and after that, I would give myself permission to supplement with formula, because it would be a miracle if I made it that far.

The babies did get a little bit of formula in their first few days. My colostrum was mixed with a few cc’s of preemie formula to make up for lack of volume, but they DID get my precious drops as well. In their first 3 days they received a couple ounces of formula between the three of them. TOTAL. And then I started producing enough to feed them exclusively my milk. It helped that Abby started out with 2.5 cc feeds and Ellie and Sam started out with 4cc feeds, so the demand wasn’t huge from the start. They were still getting the bulk of their nutrition through a TPN at that point while they figured out the whole suck/swallow/breathe thing.

And on Day 4, my husband asked the nurse how long it would be before I could try actually breastfeeding my babies, and she checked with the doctor and got permission for me to breastfeed them. She helped me get set up with Sam and showed me how to hold him and support him, and I fretted about whether he’d be able to latch, but he did! He didn’t latch on for very long, but he definitely knew what to do and figured it out pretty quickly. He tired very quickly, so we gave him a feeding through his gavage tube afterward, but it was miraculous. I had no idea how amazing an experience nursing my baby could be until that moment. It felt strange and awkward and perfect and amazing all at the same time. My tiny little three and a half pound baby knew what to do and he nursed like a little champ! How incredible. And then it was time for Ellie’s feeding, but she was having a harder time, so we gave her a gavage feeding while she was nursing so that she could associate a full tummy with mommy’s breast…a technique we employed a lot with her in the NICU, actually. I was shocked at how exhausted I was after nursing just two tiny babies. Abby was still too small to try to nurse, so when her turn came, I held her skin-to-skin while giving her a gavage feeding, and then I pumped afterward while gazing at my beautiful two and a half pound angel and had the best production I’d ever had before. It was amazing to see that it was all true… being around your babies really DOES improve milk supply. Who knew?

And that was my first day breastfeeding my babies. The next day, believe it or not, I was able to breastfeed all three of them, even Abby, and I breastfed them at least twice a day every day until they left the NICU and I pumped 8-12 times per day, every day. And then, on day 24, they came home. My once champion breastfeeders suddenly would not breastfeed anymore. None of them! I continued to pump 8-10 times per day, fed them expressed milk, attempted to breastfeed them at every feed, and never slept, because of the constant fight to get them to remember how to breastfeed. I thought all was lost. I developed my second clogged duct and was in misery until it resolved. And then… a few days later I woke up with painful, red, tender, swelling in my breast, a high fever, chills, flu-like symptoms… you guessed it, mastitis! The way to get through mastitis, I’m told, is to let your baby nurse as much as possible, but my babies wouldn’t help me, so I gave up for a few days and just pumped, pumped, pumped, pumped and pumped some more. And gradually, it got better, and I was able to see the light at the end of the tunnel.

I thought there was no way my babies would ever return to nursing… but on the advice of a nurse, I got some nipple shields, even though lots of people told me that nipple shields would only lead to nipple confusion. Seriously…these babies were drinking from bottles, so how much more confused could they get? And lo and behold… suddenly, Ellie was nursing. Then Sam was nursing. Only Abby remained skeptical. She would latch occasionally, but would usually scream her head off at the mere mention of breastfeeding (er, that might be a SLIGHT exaggeration). And eventually I was able to rid myself of the nipple shields all together and I had two, perfectly normal nursing babies and one baby who would not nurse, but who still received only expressed breast milk.

I called the pump my FOURTH baby, because I spent as much time with her (I named her Maggie) as I did with my three babies, in order to make sure I always had enough milk for Abby. And pump, I did. I was able to reduce to 6-8 times per day without changing the amount I was producing, since I was nursing so much, and I still got lots of snuggle time with my beautiful Abby. Even today I still try to give her the opportunity to nurse occasionally, but she still hates it. She’s got a tongue-tie, and has a really hard time latching, so it’s not shocking that she won’t nurse, but it’s a little disappointing.

My babies will be five months old next week and today, for the first time, I’m faced with the need to supplement them with formula. I’ve finished my stash of milk in the freezer. And I’m pumping like mad. But I’m producing 40-45 ounces of milk per day in addition to whatever they get via nursing directly, and the three babies together are eating 52 ounces of milk per day, so I’m falling a little bit short on the supply. I’ve tried everything… domperidone, fenugreek, blessed thistle, some weird herbal concoction, reglan, oatmeal, breast compression before and during pumping… but I just can’t produce more than I’m producing now, without adding additional pumping sessions in each day. I’m pumping about 6-7 times per day right now, and if I pump any more than that, I’ll probably lose my job.

A piece of me feels like a big, giant failure, even though I’m obviously not going to STOP breastfeeding and pumping at this point. I’m not sure when my 6 week breastfeeding goal turned into a 3 month goal, or when that 3 month goal turned into a 6 month goal, or when that 6 month goal turned into a 6-month-adjusted goal, but I know now that I’ll breastfeed as long as I can, as much as I can until they’re a year old, and then I’ll work on weaning them before moving on to my next round of fertility treatments. I’m not getting any younger, but I do want at least one more chance at this pregnancy thing. And I want my children to have lots of siblings. I had only one and he loathes me, so I’ve been determined my whole life to make sure that my children are surrounded with a big brood. They don’t all have to like each other (though that would be nice), but at least the odds are good that they’ll each find SOMEONE to love in the family.

But I digress. I do feel like I’m failing my children, though I don’t feel that way toward any other woman who feeds their babies formula. I’ve told countless mothers of multiples that they should not ever beat themselves up over their breastfeeding decisions because it’s HARD, and sometimes darned near impossible. And I know I should celebrate my five months of accomplishment, rather than focusing on my failure to continue the same pace, but I just can’t get past it. I know very few women who made it through five months of feeding triplets only breast milk… so I should be thrilled, right?

But then this morning, the first morning that I was guaranteed that the babies weren’t going to have enough of my own milk for the day, the guilt poured on. I thought it would be wise to try giving Abby a bottle of formula while there was still breastmilk in the fridge, just in case she didn’t like it. After all… what would we do if she refused it and there were no other options? So when the nanny arrived this morning, I handed her a bottle of formula (no way was I going to be the one to give her the yucky stuff). Sure enough, Abby screamed her little head off. My poor persnickety Abby wanted NOTHING to do with the formula. NOTHING. I thought maybe she just wasn’t hungry, but we gave her a bottle of breastmilk and, sure enough, she gobbled it right up. Sigh. Sam, fortunately, had no problem drinking the formula, little piggy that he is. Next week, I’ll try making 50/50 bottles and see what happens with Abby, but oh gosh, my heart was breaking knowing how much she hated the taste of the formula! I was completely failing my child! Thank heavens I tried it out while there were still options!

In a couple months, we’ll be starting them with some solids, and eventually their consumption of milk each day will go down slightly, so I may actually be able to return to being able to feed them 100% breast milk. But for now, each of them will probably get 2-4 ounces of formula each day. And I know that’s still pretty amazing on my part. And I know there’s nothing to be done, and no way for me to get around it.

And once again, I feel like a failure. Once again, I feel like my body is betraying me. It’s infertility all over again, even though I know that logically, this is the polar opposite of infertility. Somehow, I simply MUST make myself okay with supplementing, because there’s really nothing wrong with it. It won’t hurt my babies. They’ll still grow and they’ll still be healthy. I’ll still be able to fortify for the extra calories that Ellie needs. I’ll still be able to breast feed any time I’m home and feed them breast milk most of the time. 2-4 ounces per day just isn’t the end of the world, so why do I feel like the world’s worst mommy?

~~~~~~~~~~~~~~
Also, a quick update on Ellie… at her appointment yesterday she hadn’t gained any weight, but on Wednesday we were able to convince her to start taking 120 ml bottles, so we’re hoping another week of that will be enough to boost her back toward gaining. Bigger babies need more calories to grow, of course, so hopefully that’s all that’s going on. For the moment, she is a bit of an enigma, but she’s definitely improving. She’s more alert, and smiling and cooing almost as much as Abby now. She looks good, but is still far more sleepy than the other two. We’ll go back in a week to see how she’s improved.

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On Breastfeeding Triplets

Posted in breastfeeding, failure to thrive, my stupid body on February 15, 2008| 27 Comments »

You're pregnant with triplets? Well, you're obviously not going to breastfeed them, you're going to spend a fortune on formula!

I heard that a lot when I was pregnant. Over and over, I heard unsolicited opinions from people telling me that there was no way I would ever be able to breastfeed triplets. It's not possible, they would say. I didn't even bother trying with my twins, I would hear. Why would you even think about it? You'll never do anything but feed them all day long if you try! the incredulous voices would cry. They'll be preemies. You can't breastfeed preemies, you know.

I never expected to be the militant type…certainly not about breastfeeding, and certainly not about breastfeeding triplets. But these constant, unsolicited words of discouragement absolutely convinced me that I was going to do everything I could to breastfeed my babies, at least for the first few weeks. My premature babies were going to NEED the benefit of my colostrum and my milk for as long as I could give it to them, and I knew it wouldn't be forever, and even during my pregnancy, I mourned the loss of the ability to just KNOW that I could breastfeed with reckless abandon, but I set a modest goal. I wanted to get 3-4 weeks of exclusive breast milk into them if I could. And if I could do that, well, we'd go for 6 weeks and after that, I would give myself permission to supplement with formula, because it would be a miracle if I made it that far.

The babies did get a little bit of formula in their first few days. My colostrum was mixed with a few cc's of preemie formula to make up for lack of volume, but they DID get my precious drops as well. In their first 3 days they received a couple ounces of formula between the three of them. TOTAL. And then I started producing enough to feed them exclusively my milk. It helped that Abby started out with 2.5 cc feeds and Ellie and Sam started out with 4cc feeds, so the demand wasn't huge from the start. They were still getting the bulk of their nutrition through a TPN at that point while they figured out the whole suck/swallow/breathe thing.

And on Day 4, my husband asked the nurse how long it would be before I could try actually breastfeeding my babies, and she checked with the doctor and got permission for me to breastfeed them. She helped me get set up with Sam and showed me how to hold him and support him, and I fretted about whether he'd be able to latch, but he did! He didn't latch on for very long, but he definitely knew what to do and figured it out pretty quickly. He tired very quickly, so we gave him a feeding through his gavage tube afterward, but it was miraculous. I had no idea how amazing an experience nursing my baby could be until that moment. It felt strange and awkward and perfect and amazing all at the same time. My tiny little three and a half pound baby knew what to do and he nursed like a little champ! How incredible. And then it was time for Ellie's feeding, but she was having a harder time, so we gave her a gavage feeding while she was nursing so that she could associate a full tummy with mommy's breast…a technique we employed a lot with her in the NICU, actually. I was shocked at how exhausted I was after nursing just two tiny babies. Abby was still too small to try to nurse, so when her turn came, I held her skin-to-skin while giving her a gavage feeding, and then I pumped afterward while gazing at my beautiful two and a half pound angel and had the best production I'd ever had before. It was amazing to see that it was all true… being around your babies really DOES improve milk supply. Who knew?

And that was my first day breastfeeding my babies. The next day, believe it or not, I was able to breastfeed all three of them, even Abby, and I breastfed them at least twice a day every day until they left the NICU and I pumped 8-12 times per day, every day. And then, on day 24, they came home. My once champion breastfeeders suddenly would not breastfeed anymore. None of them! I continued to pump 8-10 times per day, fed them expressed milk, attempted to breastfeed them at every feed, and never slept, because of the constant fight to get them to remember how to breastfeed. I thought all was lost. I developed my second clogged duct and was in misery until it resolved. And then… a few days later I woke up with painful, red, tender, swelling in my breast, a high fever, chills, flu-like symptoms… you guessed it, mastitis! The way to get through mastitis, I'm told, is to let your baby nurse as much as possible, but my babies wouldn't help me, so I gave up for a few days and just pumped, pumped, pumped, pumped and pumped some more. And gradually, it got better, and I was able to see the light at the end of the tunnel.

I thought there was no way my babies would ever return to nursing… but on the advice of a nurse, I got some nipple shields, even though lots of people told me that nipple shields would only lead to nipple confusion. Seriously…these babies were drinking from bottles, so how much more confused could they get? And lo and behold… suddenly, Ellie was nursing. Then Sam was nursing. Only Abby remained skeptical. She would latch occasionally, but would usually scream her head off at the mere mention of breastfeeding (er, that might be a SLIGHT exaggeration). And eventually I was able to rid myself of the nipple shields all together and I had two, perfectly normal nursing babies and one baby who would not nurse, but who still received only expressed breast milk.

I called the pump my FOURTH baby, because I spent as much time with her (I named her Maggie) as I did with my three babies, in order to make sure I always had enough milk for Abby. And pump, I did. I was able to reduce to 6-8 times per day without changing the amount I was producing, since I was nursing so much, and I still got lots of snuggle time with my beautiful Abby. Even today I still try to give her the opportunity to nurse occasionally, but she still hates it. She's got a tongue-tie, and has a really hard time latching, so it's not shocking that she won't nurse, but it's a little disappointing.

My babies will be five months old next week and today, for the first time, I'm faced with the need to supplement them with formula. I've finished my stash of milk in the freezer. And I'm pumping like mad. But I'm producing 40-45 ounces of milk per day in addition to whatever they get via nursing directly, and the three babies together are eating 52 ounces of milk per day, so I'm falling a little bit short on the supply. I've tried everything… domperidone, fenugreek, blessed thistle, some weird herbal concoction, reglan, oatmeal, breast compression before and during pumping… but I just can't produce more than I'm producing now, without adding additional pumping sessions in each day. I'm pumping about 6-7 times per day right now, and if I pump any more than that, I'll probably lose my job.

A piece of me feels like a big, giant failure, even though I'm obviously not going to STOP breastfeeding and pumping at this point. I'm not sure when my 6 week breastfeeding goal turned into a 3 month goal, or when that 3 month goal turned into a 6 month goal, or when that 6 month goal turned into a 6-month-adjusted goal, but I know now that I'll breastfeed as long as I can, as much as I can until they're a year old, and then I'll work on weaning them before moving on to my next round of fertility treatments. I'm not getting any younger, but I do want at least one more chance at this pregnancy thing. And I want my children to have lots of siblings. I had only one and he loathes me, so I've been determined my whole life to make sure that my children are surrounded with a big brood. They don't all have to like each other (though that would be nice), but at least the odds are good that they'll each find SOMEONE to love in the family.

But I digress. I do feel like I'm failing my children, though I don't feel that way toward any other woman who feeds their babies formula. I've told countless mothers of multiples that they should not ever beat themselves up over their breastfeeding decisions because it's HARD, and sometimes darned near impossible. And I know I should celebrate my five months of accomplishment, rather than focusing on my failure to continue the same pace, but I just can't get past it. I know very few women who made it through five months of feeding triplets only breast milk… so I should be thrilled, right?

But then this morning, the first morning that I was guaranteed that the babies weren't going to have enough of my own milk for the day, the guilt poured on. I thought it would be wise to try giving Abby a bottle of formula while there was still breastmilk in the fridge, just in case she didn't like it. After all… what would we do if she refused it and there were no other options? So when the nanny arrived this morning, I handed her a bottle of formula (no way was I going to be the one to give her the yucky stuff). Sure enough, Abby screamed her little head off. My poor persnickety Abby wanted NOTHING to do with the formula. NOTHING. I thought maybe she just wasn't hungry, but we gave her a bottle of breastmilk and, sure enough, she gobbled it right up. Sigh. Sam, fortunately, had no problem drinking the formula, little piggy that he is. Next week, I'll try making 50/50 bottles and see what happens with Abby, but oh gosh, my heart was breaking knowing how much she hated the taste of the formula! I was completely failing my child! Thank heavens I tried it out while there were still options!

In a couple months, we'll be starting them with some solids, and eventually their consumption of milk each day will go down slightly, so I may actually be able to return to being able to feed them 100% breast milk. But for now, each of them will probably get 2-4 ounces of formula each day. And I know that's still pretty amazing on my part. And I know there's nothing to be done, and no way for me to get around it.

And once again, I feel like a failure. Once again, I feel like my body is betraying me. It's infertility all over again, even though I know that logically, this is the polar opposite of infertility. Somehow, I simply MUST make myself okay with supplementing, because there's really nothing wrong with it. It won't hurt my babies. They'll still grow and they'll still be healthy. I'll still be able to fortify for the extra calories that Ellie needs. I'll still be able to breast feed any time I'm home and feed them breast milk most of the time. 2-4 ounces per day just isn't the end of the world, so why do I feel like the world's worst mommy?

~~~~~~~~~~~~~~
Also, a quick update on Ellie… at her appointment yesterday she hadn't gained any weight, but on Wednesday we were able to convince her to start taking 120 ml bottles, so we're hoping another week of that will be enough to boost her back toward gaining. Bigger babies need more calories to grow, of course, so hopefully that's all that's going on. For the moment, she is a bit of an enigma, but she's definitely improving. She's more alert, and smiling and cooing almost as much as Abby now. She looks good, but is still far more sleepy than the other two. We'll go back in a week to see how she's improved.

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My Place in the Blogosphere (Updated)

Posted in blogarama on February 12, 2008| 25 Comments »

I've been contemplating the fate of this blog of mine… whether it really belongs here or not, in more ways than one. First, there's the simple question of whether I should stick with Blogger or move to Typepad or WordPress. I loathe WordPress, but I like that you can password protect individual entries, so it's tempting, though I'm entirely too lazy to make it happen anytime soon. Typepad is even more tempting, though I'm not sure I'm willing to fork over the cash to blog, since, well, this is, in essence, a useless pastime of mine. Mostly, I think I should switch to TypePad, but I've been saying that for two years, so my guess is that I'll be sticking with Blogger for the moment.

But the more pressing question is whether this blog even belongs here at all, in its present form. I don't know what my place in the blogosphere is anymore, and I know in some ways, I don't fit in and I never have… I never entirely fit the mold of a good and proper infertility blogger… I had primary infertility, but I had a foster son, so I wasn't a childless primary infertile, so I wasn't going through your typical primary infertility experience. On the other hand, I wasn't exactly going through secondary infertility either, was I? Still, I found my place in the infertility blogosphere, one way or another. And then I became one of "those people"… one of those bloggers who wrote about "pregnancy after infertility" and then "pregnancy loss after infertility" and then "pregnancy with higher order multiples after pregnancy loss after infertility". And now I'm a Mother of Multiples (MoM for short). And like many MoM's, I am parenting my multiples after experiencing infertility, so my life isn't JUST about the experience of parenting multiples. My perspective will forever be tainted with the infertility glasses. Some women move past infertility, but I don't think I ever will. Particularly since, crazy as it sounds, I want more kids and I know I can't "just" decide to have more.

But where do I fit? I hesitate sometimes to comment on infertility blogs these days, because do you really want a MoM commenting on your blog? (I don't know, I mean, really? Do you?) But I feel just as out of place on just plain parenting blogs (unless they're about parenting after infertility or about triplets or whatever…there has to be some common bond).

In some ways the name "My Perky Ovaries" isn't right anymore, except in other ways, it's more right than ever.

So what do I do? Do I stay here? Do I change my blog name? Do I make it more of a parenting blog? Do I stick with the whole infertility thing? (Considering that I plan to return to the fertility clinic for another round of fertility hell no later than the end of this year or beginning of next year, my guess is I'm sticking with the infertility thing) Do I start a whole new all-inclusive blog? Do I keep this blog for the infertility musings and start a separate parenting blog? Is that too much work? Do my infertile friends mind reading about my kids? Do I just realize that on some level we all hope and pray that someday ALL of us stirrup queens are writing about our kids so we can't ALL sit around being bitter about the kids that result from all these treatments? I don't know, maybe we can.

I think moving or abandoning this blog would be a bit on the tragic and somewhat melodramatic side. I get about 5,000 pageloads per week… about 3500 unique visitors per week… visitors from about all over the world. These are facts and figures that astound me, and surprise me whenever I see them on my statcounter summary. But they are there, every week, confirmed all the time. So… what to do.

Maybe I should just retire from this whole blogging business all together. I haven't been much of a good blogger anyway. But I'd be sad to leave my blog. Too sad, I think. So I don't think you'll luck out and be rid of me just yet. But for tonight, that's all you're getting out of me. I'm just too tired to be eloquent, even though I have far too much to say about the blessings in my life. It's been a long couple of weeks, and all the exhaustion of the last couple of months is finally catching up to me.

Your thoughts, as always, are appreciated.

Update:
Thanks for all your kind comments. I really wasn't trying to fish for compliments, but gosh, you all gave me lots of warm fuzzies. I don't think it's likely that I would actually stop blogging all together (Jess would KILL me!). I started my blog for me and only me, and if other people happen to read it, well, I find it amusing that anyone else would be interested in this dull life of mine, but I'm flattered. But I sometimes worry that I give a false impression of myself by passing this off as an infertility blog (what with the title and all), when I've got four kids (though, obviously, I fought hard for all of my children, including my foster son). But to discard the infertility label all together… well, that seems just as disingenuous. So anyway, here I will stay, and I'll post about… well, whatever. And you'll read it or you won't. And maybe I'll switch blogging services (most likely to Typepad), but I probably won't, because, you know, I've been threatening to move over to Typepad for, oh, two years now and I'm just too lazy and I don't want to have my archives scattered between two blogs and I'm too stupid to have a manual back up of my blog (which I really ought to do at some point, don't you think?). But the bottom line is, the Perky Household isn't likely to go anywhere, so you're stuck with me for the moment.

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two steps forward, one step back

Posted in failure to thrive on February 10, 2008| 11 Comments »

Ellie lost four ounces.

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two steps forward, one step back

Posted in failure to thrive on February 10, 2008| 11 Comments »

Ellie lost four ounces.

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Self Esteem

Posted in the great inflated ego on February 8, 2008| 9 Comments »

Yesterday, the nurse manager at my pediatrician’s office came out to the waiting room to coo at someone’s baby and took several minutes to recognize me. I only had one baby with me, see, and besides, that she claims not to have recognized me since I apparently am continuing to lose weight (I’m not still losing much weight, but I think it continues to re-distribute). Those of you who have met me in person know that I’m anything but slender, but if you knew me pre-triplets, you know that I *have* lost a great deal of weight. I’m down about 70 pounds from my pre-pregnancy weight, but before you get all impressed, I still have 30 or 40 pounds to lose before I’m anywhere near my “ideal” weight.

Still, it felt great yesterday to hear the nurse say, “Oh my goodness, I didn’t even recognize you, skinny mama!” and then she turned to one of the other mothers in the waiting room and told her I was a new mother to triplets and the mother looked at me and said, “You look AMAZING!” In fact, every time someone in my doctor’s waiting room finds out I’m a mother to triplet infants, they tell me how fantastic I look. This must be why I love my pediatrician so much!

And then when I left the office, I ran into a member of my synagogue whom I haven’t seen since I was on bed rest, when she paid a shiva visit to my husband last summer. And she couldn’t get over how I looked. “You look incredible!” she said.

Gosh. Thanks!

I know I still have a really long way to go before I’m anywhere near where I’d like to be… but gosh… it’s so nice that people notice that there’s been SOME change. And it’s nice that perfect strangers feel compelled to tell me I look great when they hear that I’ve got triplets. I’ve been feeling a bit blue the past couple weeks, but these little ego boosts are really kind of helping. So… wow!

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